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1.
Clin Endocrinol (Oxf) ; 58(2): 156-62, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12580930

RESUMO

OBJECTIVE: Reduction of plasma free fatty acids leads to enhanced GH response after stimulation by GH-releasing hormone (GHRH). We studied the clinical usefulness of combined administration of acipimox and GHRH for the diagnosis of GH deficiency. DESIGN: We evaluated 35 patients [mean age 53.0 years; mean body mass index (BMI) 26.7 kg/m2] after pituitary surgery. We compared GH responses after acipimox and GHRH with the GH response during an insulin tolerance test (ITT) and, in a subgroup of 12 patients, with the GHRH/arginine test. The acipimox/GHRH test was additionally performed in 21 control subjects (mean age 53.8 years; mean BMI 24.7 kg/m2). RESULTS: In the patients, the mean (+/- SEM) peak GH was almost four-fold higher after acipimox/GHRH (6.94 +/- 1.07 microg/l, range 0.46-23.1; P < 0.001) and after GHRH/arginine (8.32 +/- 1.23 microg/l, range 1.1-49.2; P < 0.001) than after ITT (1.84 +/- 0.46 microg/l, range 0.01-11.9). According to the ITT, 29 patients were severely GH deficient (peak GH < 3.0 microg/l). Peak GH levels after acipimox/GHRH in controls ranged from 7.5 to 78.4 microg/l (mean 29.3 +/- 3.5). GH peak values during the acipimox/GHRH test were significantly correlated with values from the ITT (r = 0.63, P < 0.01) and GHRH/arginine test (r = 0.87, P < 0.001). Areas under the curve were also correlated. According to generally accepted cut-off peak GH levels for the ITT and GHRH/arginine test, a GH peak exceeding 11.2 micro g/l excludes severe GH deficiency after acipimox/GHRH. Our control data indicate that the cut-off level is lower at older age. CONCLUSIONS: The acipimox/GHRH test leads to GH responses similar to those of the GHRH/arginine test, and to higher peak GH values if compared with the ITT. The acipimox/GHRH test is a potential additional tool to detect GH deficiency in patients with pituitary disease, in particular in patients with a perturbation of fatty acid metabolism.


Assuntos
Adenoma/cirurgia , Hormônio Liberador de Hormônio do Crescimento , Hormônio do Crescimento/deficiência , Neoplasias Hipofisárias/cirurgia , Pirazinas , Adenoma/sangue , Adolescente , Adulto , Idoso , Área Sob a Curva , Arginina , Ácidos Graxos não Esterificados/sangue , Feminino , Hormônio do Crescimento/sangue , Humanos , Insulina , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/sangue , Valor Preditivo dos Testes , Estimulação Química
2.
J Belge Radiol ; 74(1): 31-2, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-2022604

RESUMO

A case of mediastinal teratoma is described with emphasis on its magnetic resonance aspect. All the components of the mass were well defined. The major interest of magnetic resonance imaging in this case consisted in the good delineation of the pericardium and visualization of the absence of pericardial invasion.


Assuntos
Imageamento por Ressonância Magnética , Neoplasias do Mediastino/diagnóstico , Teratoma/diagnóstico , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Teratoma/diagnóstico por imagem , Teratoma/cirurgia
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